Abstract：Objective: To analyze the complications of further pregnancy at advance age of women with scar uterus,and to provide a theoretical basis for the timing of re-pregnancy and the choice of delivery mode for primipara.Methods: We selected 210 cases of scar uterus multiparae in our hospital from January 2017 to December 2018,of which 105 cases were in the advanced age group,age ≥35 years,and 105 cases in the control group,age <35 years.Data of pregnancy complications and perinatal complications were collected in detail.Results: 1.Comparison of the general items:The advanced age group has larger data of age,pregnancy times,abortion/curettage times and the interval from the last cesarean section than those of the control group,and the differences were significant statistical (P<0.01). 2.Comparison of pregnancy complications:The incidence of gestational diabetes mellitus,preeclampsia,premature rupture of membranes and uterine leiomyoma in the advanced age group was significantly higher than that in the control group,and the difference was statistically significant (P<0.05);In preterm labor,placenta previa,placental abruption,hydramnios,oligohydramnios,HELLP syndrome,gestational hypothyroidism,the advanced age group had higher data than the control group,but the difference is not statistically significant (P>0.05).3.Comparison of perioperative complications:The intraoperative bleeding volume,operating time and perioperative complications in the advanced age group were higher than those in the control group (P<0.01).The advanced age group had higher data of postpartum hemorrhage,uterine contraction fatigue,placenta accreta,placental adhesion,pelvic adhesion,intraoperative secondary injury,blood transfusion,postoperative fever,postoperative intestinal obstruction,and poor wound healing,but there is no statistical difference (P>0.05). 4.Comparison of fetal and neonatal adverse events:Both gestational weeks and neonatal birth weight in the advanced age group were less than those in the control group,but there was no significant difference (P>0.05);The incidence of perinatal adverse events in the advanced age group was significantly higher than that in the control group,and the difference was statistically significant(P<0.05).And the proportion of neonatal asphyxia and transference to NICU was significantly higher(P<0.05).Conclusion: The incidence of complications of gestational diabetes mellitus,preeclampsia,premature rupture of membranes and hysteromyoma of advanced age group was 2.1,2.8,2.4 and 4.8 times higher than that of control group,and the incidence of perioperative complications and perinatal complications of advanced age group is higher at that.Therefore,it suggests that early pregnancy is meaningful in avoiding the high risk of advanced age pregnancy.At the same time,couples with more than one child requirement should choose vaginal delivery at first labor to reduce the cesarean section caused by social factors,and thus reduce complications of the perinatal and pregnant women.
任春丽, 唐兴国, 张玉芳, 袁晓明, 张金环, 郭艳巍. 二孩后瘢痕子宫高龄孕妇再妊娠并发症发生情况分析[J]. 河北医学, 2020, 26(11): 1919-1923.
REN Chunli, et al. A Complication Analysis of Further Pregnancy of Women at Advanced Maternal Age with Scar Uterus. HeBei Med, 2020, 26(11): 1919-1923.
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2020, Vol. 26 
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